The Evolution of Dental Radiography: From the first X-ray to AI

Dentistry has advanced significantly since the discovery of x-rays in 1895, revolutionising how we view the internal structures of the mouth, beneath the gums. What began as an innovative way to reveal what’s hidden from the human eye, has evolved into highly advanced digital technology, allowing for advanced diagnostics and precise treatment planning.

However, as we celebrate these advancements, it’s important to remember that x-ray machines emit ionising radiation, making safety measures and compliance with radiation regulations just as important as embracing the technology.

The early days: A breakthrough in dental care

The journey began in 1895 when German physicist Dr. Wilhelm Röntgen discovered x-rays during experiments with a cathode-ray tube. He observed their ability to penetrate through certain materials, making the previously invisible visible. 

December 1895: Dr. Wilhelm Röntgen took the first radiograph of his wife’s hand, clearly showing the bones and her wedding ring.

Within just two months, dentists recognised the potential of this discovery as a non-invasive method to examine the internal structures of the mouth. In January 1896, Dr. Otto Walkhoff, a pioneering dentist and innovator, made history by taking the first dental radiograph—of his own teeth. Though these early x-rays were rudimentary and lacked diagnostic quality, they paved the way for decades of research and technological advancement.

January 1896: Dr. Otto Walkhoff took the first dental radiograph of his own teeth by placing a photographic plate in his mouth and subjecting himself to 25 minutes of x-ray exposure—a considerably long and unsafe duration by today’s standards.

Fun fact: X-rays got their name from Röntgen, who labelled them “X” for the mathematical symbol of the unknown, because he wasn’t sure what type of radiation they were. The name certainly stuck!

The shift from film to digital radiography

For much of the 20th century, dental radiographs were captured on photorealistic type film, which required development in dark rooms. These images provided enough detail for dentists to diagnose issues but still left room for improvement.

For many years, photorealistic film was used to capture radiographs, which were processed in dark rooms, much like traditional film photography.

The real leap forward came in the 1980s with the introduction of digital radiography. This was a major advancement, delivering sharper images, faster processing times, and the convenience of instant review on a computer screen. By the 1990s, digital radiographs had become the standard in most dental practices, though a few film enthusiasts held on until the mid-2010s (no offence to anyone still rocking the retro vibe!).

The transition from film to digital wasn’t just about speed and convenience—it also significantly improved diagnostic accuracy. While film radiographs display 25-30 shades of grey, digital radiographs can display up to 256 shades of grey per pixel. These days, modern bitewing, PA, or OPG images contain between 1 and 6 million pixels, dramatically enhancing image detail.

Digital radiographs marked a significant advancement in dentistry, offering enhanced image quality and faster processing times

The digital age: AI in dental radiography

Today, we’re witnessing another revolution in dental imaging—artificial intelligence (AI). AI-powered systems are now being used to assist in interpreting radiographs, flagging areas of interest and helping dentists diagnose conditions earlier and with greater accuracy. Why is this so important? While technology has advanced, our biological anatomy has not. Even though each pixel of a modern radiograph can show up to 256 shades of grey, the human eye can only distinguish between 40-60 shades.

Radiologic AI platforms, such as Pearl’s Second Opinion®, enable dentists to detect up to 37% more disease in radiographs.

This is where AI comes in. AI has no such limitations and can analyse subtle nuances with incredible precision. Dentists who utilise this cutting-edge technology can overcome the inherent limitations of human vision, allowing them to make more accurate diagnoses and ensure their patients receive the highest standard of care.

Safety first: Embrace technology, stay compliant

The evolution of dental radiography has been truly remarkable, bringing immense benefits to both patients and practitioners. However, with this powerful technology comes the responsibility to prioritise safety and regulatory compliance.

While technological advancements have significantly reduced radiation doses in dental x-rays and protective measures are in place, it’s important to remember that these machines still emit ionising radiation. If not properly managed, this can pose health risks.

Over time, x-ray equipment can deteriorate, suffer inadvertent damage, or develop internal faults due to extensive use. These issues can lead to inconsistencies in radiation output, higher leakage levels, or other potential risks to both staff and patients. That's why it’s critical to adhere to your local radiation regulations to ensure everyone in your practice is protected from unnecessary exposure to ionising radiation.

If you’re based in NSW and have questions about radiation regulations or would like to book an appointment for the mandatory compliance certification for your x-ray equipment, Gamma Tech is here to help.